丙泊酚在先天性心脏病心导管检查麻醉中的应用  

Effect Evaluation of Propofol during Anaesthesia of Cardiac Catheterization for Children with Congenital Heart Disease

作　　者：刘一华[1] 李锁北[2] 唐建军[2] 

机构地区：[1]湖南省永州市人民医院麻醉科,永州425000 [2]中南大学湘雅二医院,长沙410011

出　　处：《中国现代手术学杂志》2008年第3期226-228,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨丙泊酚在小儿先天性心脏病心导管检查麻醉中的效果及安全性。方法34例先心病患儿,紫绀型19例,非紫绀型15例,诱导前肌注氯胺酮0.5-1 mg,丙泊酚1.5 mg/kg,芬太尼3μg/kg诱导后,丙泊酚50μg/（kg.min）持续泵入,比较两组麻醉效果。结果所有患儿镇静、镇痛效果满意。与非紫绀组比较,紫绀组麻醉前心率稍快、SpO2明显降低,紫绀组药物起效时间短（P〈0.05）,但麻醉苏醒时间和检查时间两者无显著差异（P〉0.05）。两组麻醉前、麻醉中和苏醒后RR、SpO2比较均无显著差异,但麻醉中HR较麻醉前快、MAP较麻醉前升高（P〈0.05）。所有病人在心内操作中均观察到室性或房性心律失常。术后两组各有1例病人出现恶心、呕吐,无其他麻醉相关并发症。结论小儿先天性心脏病心导管检查麻醉中应用丙泊酚安全有效。Objective To assess the safety and effect of propofol for anaesthesia of cardiac catheterization in children with congenital heart disease（CHD）.Methods 34 CHD children were underwent cardiac catheterization,including 19 with cyanosis（cyanosis group） and 15 without cyanosis（non-cyanotic group）.The anesthesia was inducted by fentanyl l3μg/kg and maintained by propofol 50μg/（kg·min）. Results The satisfied effect of sedation and analgesia were achieved in all children.Compared with the non-cyanotic group,HR of pre-anaesthesia was faster,SpO2 of pre-anaesthesia was lower,and the onset time was shorter in the cyanosis group（P〈0.05）.But no significant difference was found in analepsia or examine duration between the two groups（P〉0.05）.Intra-group comparisons of both 2 groups showed： no remarkable difference of RR and SpO2 at pre-,intra-anaesthesia and after analepsia,whereas the HR was faster and MAP was higher at intra-anaesthesia than those at pre-anaesthesia.Ventricular or atrial arrhythmia was observed in all cases during the cardiac catheterizing.Nausea and vomit occurred in 1 case for each group.No other complication associated with anaesthesia was found.Conclusion Propofol is safe and effective for anaesthesia of cardiac catheterization in children with CHD.

关 键 词：心脏导管插入术 麻醉 全身 二酚异丙 儿童 

分 类 号：R726.1[医药卫生—儿科]